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5- Antimicrobial Agents Flashcards

(70 cards)

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1
Q

Antibiotics acting through Inhibition of cell wall synthesis ?

A 
Penicillins 
Cephalosporins 
Imipenem/Meropenem 
Aztreonam 
Vancomycin
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2
Q

Antibiotics acting through inhibition of bacterial protein synthesis ?

A 
Aminoglycosides 
Chloramphenicol 
Macrolides 
Tetracyclines 
Streptogramines 
Linezolid 
Clindamycin
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3
Q

Antibiotics acting through inhibition of nucleic synthesis ?

A

Fluoroquinolones

Rifampin

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4
Q

Antibiotics acting through inhibition of folic acid synthesis ?

A

Sulfonamides
Trimethoprim
Pyrimethamine

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5
Q

Narrow spectrum penicillins ? Their spectrum ?

A

Penicillin G
Penicillin V

Streptococci
Pneumococci
Meningococci
Treponema pallidum

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6
Q

Very narrow spectrum penicillins ? Their spectrum ?

A

Nafcillin
Oxacillin
Methicillin

Staphylococci

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7
Q

Broad spectrum penicillins ? Their spectrum ?

A

Amoxicillin
Ampicillin

Both : gram +ve cocci except staph , E coli , H influenza
Ampicillin : listeria monocytogenes
Amoxicillin : borrelia , H pylori

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8
Q

Extended spectrum penicillins ? Their spectrum ?

A

Ticarcillin
Piperacillin

Increased activity against gram -ve rods including Pseudomonas

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9
Q

Examples for suicide inhibitors ?

A

Clavulanic acid

Sulbactam

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10
Q

Aminoglycosides with ticarcillin synergistic against ?

A

Pseudomonas

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11
Q

Aminoglycosides with amoxicillin synergistic against ?

A

Enterococcal species

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12
Q

Nafcillin and oxacillin eliminated largely in ?

A

Bile

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13
Q

Firist generation cephalosporins ? Their spectrum ? Use ?

A

Cefazolin
Cephalexin

Gram +ve cocci ( not MRSA )
E coli
Klebsiella pneumoniae
Some proteus species

In surgical prophylaxis

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14
Q

Second generation cephalosporins ? Their spectrum ?

A

Cefotetan
Cefaclor
Cefuroxime

Increased gram -ve coverage including some anaerobes

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15
Q

Third generation cephalosporins ? Their spectrum ? Use ?

A

Ceftriaxone IM
Cefotaxime parenteral
Cefdinir
Cefixime oral

Gram +ve and gram -ve cocci
Many gram -ve rods

Important in empiric management of meningitis and sepsis

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16
Q

Fourth generation cephalosporins? Spectrum ?

A

Cefepime IV

Wider than third generation

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17
Q

Organisms not covered by cephalosporins?

A 
LAME 
Listeria monocytogenes 
Atypicals ( Chlamydia) 
MRSA
Enterococci
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18
Q

Tubular secretion of penicillins and cephalosporins is blocked by ?

A

Probenecid

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19
Q

In case of allergy to penicillins what drugs to choose to combat bacteria ?

A

For gram +ve organisms : Macrolides

For gram -ve rods : aztreonam

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20
Q

Imipenem and Meropenem spectrum ?

A

Gram +ve cocci
Gram -ve rods
Anaerobes

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21
Q

Imipenem is given with ? Why ?

A

Cilastatin

a renal dehydropeptidase inhibitor which inhibits imipenem metabolism to a nephrotoxic metabolite

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22
Q

Aztreonam spectrum ? Mode of administration ?

A

Gram -ve rods

IV

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23
Q

Vancomycin spectrum ?

A

MRSA
Enterococci
Clostridium difficile

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24
Q

Streptomycin is the DOC for ?

A

Bubonic plague

Tularemia

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25
Antibiotics not used in pregnancy?
Aminoglycosides Fluoroquinolones Sulfonamides Tetracyclines
26
Doxycycline is useful in ttt of ?
Prostatitis
27
Minocyclin is used in ?
Meningococcal carrier state
28
Tigecyclin is used in ?
Complicated skin , soft tissue and intestinal infections
29
Antibiotics that causes phototoxicity ?
Tetracyclines Sulfonamides Quinolones
30
Chloramphenicol is metabolized by ?
Hepatic glucuronidation
31
Macrolides spectrum ?
``` Gram +ve cocci Atypical organisms Legionella pneumophila Campylobacter jejuni Helicobacter pylori Mycobacterium avium intracellulare ```
32
Telithromycin ?
A ketolide active against macrolide resistant S. Pneumonia
33
Clindamycin spectrum ?
Gram +ve | Anaerobes
34
Clindamycin side effect ?
Pseudomembranous colitis
35
Linezolid uses ?
Ttt of : VRSA VRE Drug resistant pneumococci
36
Side effects of linezolid ?
Bone marrow suppression | MOA-a and b inhibitor
37
Streptogramins ?
Dalfopristin | Quinupristin
38
Spectrum of streptogramins ?
VRSA VRE Drug resistant gram +ve cocci
39
Sulfonamides inhibit ?
Dihydropteroate synthase
40
Inhibitors of dihydrofolate reductase ?
Trimethoprim | Pyrimethamine
41
DOC in Nocardia ?
Cotrimoxazole
42
Sulfonamides are metabolized by ?
Hepatic acetylation
43
Mechanism of action of Amphotericin B and nystatin ? Their uses ?
Interact with ergosterol in fungal membranes to form artificial pores which disrupts membrane permeability Amphotericin B : DOC for severe infections caused by cryptococcus and mucor Nystatin : used topically for localized infections ( candidiasis )
44
Mechanism of action of Azoles ?
Inhibit 14-alpha demethylase
45
Itraconazole is DOC for ?
Blastomycoses Sporotrichoses Aspergillosis
46
Flucytosine mechanism of action ?
Activated by fungal cytosine deaminase to 5-fluorouracil which after triphosphorylation is incorporated into fungal RNA 5-FU also forms 5-fluorodeoxyuridine monophosphate which inhibits thymidylate synthase
47
Mechanism of action of Acyclovir ?
Monophosphorylated by viral thymidine kinase to acyclovir triphosphate which is both a substrate for and inhibitor of viral DNA polymerase When incorporated into the DNA molecule acts as a chain terminator
48
Ganciclovir uses ? Side effects ?
Mostly used in prophylaxis and ttt of CMV infections including retinitis in AIDS and transplant patients ``` Hematotoxicity Mucositis Fever Rash Crystalluria ```
49
Foscarnet side effects ?
Nephrotoxicity with acute tubular necrosis , electrolyte imbalance with hypocalcemia
50
Side effects of Zidovudine?
Hematotoxicity Myopathy Peripheral neuropathy
51
Side effects of Didanosine ?
Pancreatitis Peripheral neuropathy Hyperuricemia Liver dysfunction
52
Side effect of protease inhibitors ?
Metabolic syndrome
53
Side effect of Ritonavir ?
Induces CYP 1A2 and inhibit the major P450 isoforms ( 3A4 , 2D6 )
54
Integrase inhibitor ?
Raltegravir
55
Fusion inhibitors ?
Enfuvirtide | Maraviroc
56
MOA of Enfuvirtide?
Binds to gp41 and inhibits the fusion HIV-1 to CD4+ cells
57
MOA of Maraviroc ?
Blocks the binding of the gp120 HIV protein to CCR5 on macrophage surface to prevent viral entry
58
MOA of Zanamivir and Oseltamivir ?
Inhibit neuraminidases of influenza A and B —> decreases the likelihood that the virus will penetrate uninfected cells
59
Ribavorin MOA ?
Monophosphorylated form inhibits IMP dehydrogenase | Triphosphorylated form inhibits viral RNA polymerase and end-capping of viral RNA
60
Uses of Ribavirin ?
Adjunct to alpha interferons in hepatitis C Respiratory syncytial virus Lassa fever Hantavirus
61
Side effects of Ribavirin ?
Hematotoxic Upper airway irritation Teratogenic
62
Sofosbuvir MOA ?
Nucleotide analog that inhibits RNA polymerase
63
Simeprevir MOA ?
Hepatitis C protease inhibitor
64
Ledipasvir MOA ? Combined with ?
Inhibits HCV NS5A protein that play a key role in RNA replication Combined with Sofosbuvir
65
DOC for lechmaniasis ?
Stibogluconate
66
DOC for Trypanosomiasis ?
Chagas disease : Nifurtimox | African : Arsenicals
67
Side effects of metronidazole ?
Metallic taste | Disulfiram like action
68
Ttt of malaria in chloroquine resistant regions ?
Quinine +\- ( doxycycline or clindamycin or pyrimethamine)
69
MOA of albendazole ?
Decrease glucose uptake | Decrease microtubular structure
70
MOA of praziquantel?
Increase Ca influx | Increase vacuolization

Pharmacology (9 decks)

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